Individual
JESSICA HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
1700 E BOGARD RD, WASILLA, AK 99654-6563
(907) 357-4111
Mailing address
436 N MAIN ST, WASILLA, AK 99654-7018
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
161884
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7328868
DRIVERS LICENSE
AK
Enumeration date
07/27/2020
Last updated
02/28/2025
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